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目的探讨细胞因子诱导的杀伤细胞(CIK)联合光动力(PDT)治疗中晚期食管癌的临床疗效及对生活质量的影响。方法将收治的63例中晚期食管癌患者随机分为2组,单纯CIK组33例,行单纯CIK细胞治疗;联合治疗组30例,CIK细胞联合PDT治疗;CIK细胞培养14 d,分3次安全回输患者体内,间隔1~2 d,每次回输细胞数量>1×10~9个,活力>95%。联合治疗组:CIK细胞培养14 d,期间第12天按照5 mg/kg静脉注射光敏剂喜泊分注射液,第13天在胃镜引导下使用630 nm波长的激光进行照射,功率密度150 m W/cm~2,持续30 min,能量密度270 J/cm~2,第14天回输CIK细胞。对所有患者进行临床症状缓解率、内镜下总有效率、免疫功能及生活质量评价。结果联合治疗组临床症状缓解率(93.3%vs 60.6%)及内镜下评价总有效率(90.0%vs 63.6%)均高于单纯CIK组(P<0.01,P<0.05);两组CD3~+、CD3~+CD56~+治疗前后差异有统计学意义(均P<0.05),且治疗后联合治疗组CD3~+、CD3~+CD56~+较单纯CIK组明显上升(P<0.05);联合治疗组生活质量提高率显著高于单纯CIK组(86.7%vs 33.3%,P<0.01)。结论 CIK细胞联合光动力治疗中晚期食管癌患者,对提高患者的近期临床疗效,增强免疫功能等具有较好的临床价值。
Objective To investigate the clinical effects of cytokine-induced killer (CIK) combined with photodynamic therapy (PDT) on advanced esophageal cancer and its impact on quality of life. Methods 63 cases of advanced esophageal cancer patients were randomly divided into two groups, 33 cases of pure CIK group, CIK cells treated with simple; 30 cases of combined treatment group, CIK cells combined with PDT treatment; CIK cells cultured for 14 days, 3 times The patients were safely transfused in the patients with an interval of 1 ~ 2 days. The number of transfused cells was> 1 × 10 ~ 9 times and the viability> 95%. Combination therapy group: CIK cells were cultured for 14 days. On the 12th day, the photosensitizer was injected intravenously at a dose of 5 mg / kg, and on the thirteenth day, the cells were irradiated by a laser with a wavelength of 630 nm under the guidance of gastroscope. The power density was 150 mW / cm ~ 2 for 30 min, energy density of 270 J / cm ~ 2, CIK cells were transfused on the 14th day. To all patients clinical remission rate, the total efficiency of endoscopy, immune function and quality of life evaluation. Results The rates of clinical symptom relief (93.3% vs 60.6%) and endoscopic evaluation of total effective rate (90.0% vs 63.6%) in the combined treatment group were significantly higher than those in the CIK group (P <0.01, P <0.05) (P <0.05). After treatment, the levels of CD3 +, CD3 + CD56 + in the combined treatment group were significantly higher than those in the CIK group (P <0.05). The rate of improvement of the quality of life in the combined treatment group was significantly higher than that in the CIK group (86.7% vs 33.3%, P <0.01). Conclusion CIK cells combined with photodynamic therapy for patients with advanced esophageal cancer have a good clinical value in improving the patients’ clinical efficacy and enhancing immune function.